The present invention is directed to a retractor blade for use in surgery, a ratcheted blade holder for holding the blade to allow movement with two degrees of freedom, and the combination of the two.
It is known in the surgical arts to provide access to certain body parts during surgery by providing devices to hold certain other body parts out of the way. For example, during a liver transplant, it is often necessary to hold the rib cage up and the stomach out of the way; retaining devices having retaining blades at their ends can be attached to the above-mentioned horizontal bar to perform those functions. A well known example of that technology is a Stieber Grip sold by the assignee of the present application and shown in FIG. 1.
The Stieber Grip 101 is secured to the surgical table by a pair of clamping devices shown in dotted lines and is positioned over the patient P to hold the patient""s stomach and rib cage out of the way to allow access to the liver (internal organs not being shown in detail in FIG. 1). The assembly 101 includes, inter alia, sliding platforms 103 with ratchet mechanisms 105 for holding ratchet handles 107 with blades 109 on their ends. The ratchet engagement between the ratchet mechanisms 105 and the ratchet handles 107 allows the blades 109 to be set at desired positions, e.g., to accommodate various types of operations or patients P of various sizes. That engagement also allows the handles 107 and blades 109 to be removed altogether to insert blades 109 of different sizes or different devices altogether. The rest of the assembly and the details of its use will be readily apparent to those skilled in the art.
FIG. 2 shows the handle 107 and blade 109 in detail. As can be seen, blades 109 of various sizes and shapes can be provided. However, the blades 109 are permanently attached to the handles 107 by pivot attachments 111. Also, the pivot attachments 111 allow rotation of the blades 109 only in a single plane, or in other words with a single degree of freedom.
The following references show such blades, and the disclosures of those references are hereby incorporated by reference in their entireties into the present disclosure: U.S. Pat. No. 4,143,652, issued to Meier et al on Mar. 13, 1979; U.S. Pat. No. 4,945,897, issued to Greenstein et al on Aug. 7, 1990; A. C. Stieber, xe2x80x9cHepatic Transplantation with the Aid of the Iron Intern Retractor,xe2x80x9d The American Journal of Surgery, Vol. 160, pp. 300-01, September, 1990; and R. J. Greenstein, xe2x80x9cMechanical Retraction in Obesity and Esophagogastric Surgery,xe2x80x9d Obesity Surgery, Vol. 1, pp. 431-433, 1991.
In light of the above, it will be readily apparent that a need exists in the art for a surgical retractor blade that can move relative to its handle in more than simply a single plane, or in other words in two degrees of freedom. To this end, a primary object of the invention is to provide a surgical retractor blade that is attached to its handle for two degrees of freedom.
A further object of the invention is to provide a surgical retractor blade that is removable from its handle.
To achieve these and other objects, the present invention is directed to a surgical retractor blade and ratchet handle that are attached with a joint that allows two degrees of freedom, such as a ball-and-socket joint. The blade is rendered removable in different ways in two preferred embodiments. In one preferred embodiment, the ball-and-socket joint is configured so that the blade is normally held in the joint but can be removed as needed. The removal operation involves a relative movement between the blade and the handle that will not occur while the blade in use, so that the blade will not come off during surgery. In another preferred embodiment, the ball-and-socket joint permanently attaches a holder to the handle, and the blade is removably attached to the handle.